A 68-year-old man with a 12-year history of hypertension and type 2 diabetes mellitus presents to the emergency department with acute painless vision loss in his right eye that began 2 hours ago. He reports the vision loss was instantaneous and describes a dark curtain descending from above. He denies eye pain, flashing lights, or floaters. Vital signs are BP 168/96 mmHg, HR 88/min, RR 16/min, temperature 37.0°C, and SpO2 98% on room air. Current medications include lisinopril and metformin. Visual acuity is count fingers in the right eye. Dilated fundoscopic examination of the right eye reveals retinal whitening and edema in a wedge-shaped distribution corresponding to the superior arcade, with a cherry-red spot noted at the macula. The left eye appears normal. Carotid duplex ultrasonography shows no significant stenosis bilaterally. Which of the following is the most likely diagnosis?
- A)Branch retinal artery occlusion
- B)Central retinal vein occlusion
- C)Acute angle-closure glaucoma
- D)Central retinal artery occlusionGABARITO
- E)Amaurosis fugax with spontaneous resolution
Explicação
Central retinal artery occlusion (CRAO) presents with sudden, painless, monocular vision loss—a classic presentation of acute arterial ischemia to the retina. The fundoscopic findings of diffuse retinal whitening/edema (due to retinal ischemia) combined with t... Ver explicação completa e trilha adaptativa →